What is malnutrition?

By Dr Ananya Mandal, MD

Malnutrition is a condition which occurs when there is a deficiency of certain vital nutrients in a person’s diet. The deficiency fails to meet the demands of the body leading to effects on the growth, physical health, mood, behaviour and other functions of the body. Malnutrition commonly affects children and the elderly.

Malnutrition also entails conditions where diet does not contain the right balance of nutrients. This might mean a diet high on calories but deficient in vitamins and minerals. These second group of individuals may be overweight or obese but are still considered malnourished. Thus being malnourished does not always mean that the person is underweight or thin. (1-4)

Who is at risk of malnutrition?

Malnutrition affects all age groups but is more common in developing countries and among children, elderly and pregnant women. In the United Kingdom, 2 million people were found to be malnourished in 2009 and a further 3 million people were found to be at risk of becoming malnourished. A quarter of all admissions in the UK are due to malnutrition.

Those at a higher risk are elderly over 65, particularly if they are living at care facilities, those with long term chronic illnesses like those of the liver or kidney, those with cancer or other debilitating infections like AIDS and those who abuse drugs or are alcoholics. Malnutrition is common among the low income and homeless groups.

Worldwide malnutrition is found to be the most important cause of illness and death affecting large populations of children and pregnant women. Malnutrition kills 300,000 individuals worldwide each year and is responsible for about half of all deaths in young children and it raises the risk of infections with diarrhea, malaria, measles and respiratory tract infections in children.

According to the World Health Organization, by 2015 prevalence of malnutrition world-wide will be 17.6% and large number of malnourished population will be from developing countries in southern Asia and sub-Saharan Africa. In addition 29% will have stunted growth due to poor nutrition.

The most common symptom of malnutrition is weight loss. For example, those who lose up to 10% of their body weight in 3 months without dieting are considered to be malnourished. There may be other symptoms like fatigue, lack of energy, lack of strength, breathlessness, anemia, changes of skin, hair and nails etc. in adults with malnutrition.

Children with malnutrition additionally show irritability, inability to concentrate, failure to grow to their expected height, stunted growth etc.

Diagnosis of malnutrition

Diagnosis of malnutrition is made clinically by examining the patient. In addition the BMI or body mass index (weight in kilograms over height in metres squared – Weight/height (in m)2) and mid arm circumference.

Those with a BMI less than 18.5 need to see their health care providers for assessment of malnutrition. Children with growth retardation or stunting need to be assessed as well for signs of malnutrition. Other diagnostic tests include routine blood tests for detection of anemia, chronic infection etc.

Treatment of malnutrition

For those who can eat normally, treatment of malnutrition entails providing a diet plan with extra nutrient content. The diet plan needs to be made balanced so as to allow for weight gain along with provision of vitamins and minerals.

For those who cannot eat normally a feeding tube can be used to provide nutrients directly into the digestive system or nutrients available as injectable preparations could be infused directly into one of the blood vessels.

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